Healthcare Common Procedure Coding System (HCPCS) - Level II Code Modification Request Process

HCPCS Modification to Code Set Form (CMS-10224)

Documents and Forms

Document Name Document Type
Form CMS-10224 Healthcare Common Procedure Coding System (HCPCS) - Level II Code Modification Request Process Form and Instruction
CMS-10224 MEARIS HCPCS Level II Application Screenshots. MEARIS HCPCS Level II Application Screenshots.pdf Form and Instruction
CMS-10224 MEARIS HCPCS Level II Application Screenshots. MEARIS HCPCS Level II Application Screenshots.pdf Form and Instruction
2023 HEALTHCARE COMMON PROCEDURE CODING SYSTEM (HCPCS) LEVEL II CODING PROCEDURES.pdf HCPCS LEVEL II CODING PROCEDURES IC Document
2023 HEALTHCARE COMMON PROCEDURE CODING SYSTEM (HCPCS) LEVEL II CODING PROCEDURES.pdf HCPCS LEVEL II CODING PROCEDURES IC Document

Information Collection (IC) Details

IC Title:	Healthcare Common Procedure Coding System (HCPCS) - Level II Code Modification Request Process	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 42 CFR 414.40 45 CFR 162.10002

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	CMS-10224	MEARIS HCPCS Level II Application Screenshots.	MEARIS HCPCS Level II Application Screenshots.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 250	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	250	100	150
Annual IC Time Burden (Hours)	2,500	1,000	1,500
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
HCPCS LEVEL II CODING PROCEDURES	2023 HEALTHCARE COMMON PROCEDURE CODING SYSTEM (HCPCS) LEVEL II CODING PROCEDURES.pdf	04/12/2023

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.